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Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

1

Get theFacts

2

CompareOptions

3

YourFeelings

4

YourDecision

5

QuizYourself

6

Your Summary

Get the facts

Your options

Care for your relative at home. Some caregivers also may want
to think about part-time care at home with a health aide or a nurse or in an
adult day care.

Move your relative into a nursing home or other
long-term care, such as assisted living or a special care unit like memory care.

Key points to remember

People with
Alzheimer's or other
dementia need a safe, structured environment. You may
be able to provide this at home. In other cases, long-term care in a center is
a better choice.

People with dementia usually need more and more
care as time goes by. At some point, your relative will most likely have to be
moved to a long-term care center.

A care center may offer your
loved one some people to talk to plus activities and outings. These
social contacts may keep him or her active for as long as possible.

Caring at home for someone who has dementia takes a lot of time
and work. It also costs money if you hire part-time help. Caring for a loved
one at home also may take time away from other areas of your life. Every family
has different needs and limits to think about.

By using adult
day-care programs and part-time help—whether hired or through family and
friends—you may be able to keep your loved one at home
longer.

Remember that your own health, both physical and emotional,
is as important as that of the person you're caring for.

Deciding
to move your relative into long-term care is not a sign of failure in your role
as caregiver.

Basic activities such as eating, dressing,
bathing, using the bathroom, and simply moving around become harder or
impossible without help.

Safety is a concern. Your loved one may be
more likely to have an accident or to wander from home.

Taking care of the person at home often becomes too hard
on your body and your emotions. Your loved one's behavior can be frustrating or
dangerous. He or she may get angry or abusive. These behaviors are often the
biggest challenge for caregivers.

"Nursing home" is commonly used to refer to any long-term care, but there
are several kinds of centers. Each provides different levels of medical care,
help with daily living, programs, and support. The quality and costs of care
and services vary widely. Your community may not have all of these
choices.

Assisted-living centers usually provide private, apartment-style housing and offer a range of
services. These services may include meals, cleaning and laundry services, and
help with personal needs such as bathing, grooming, and dressing.
Assisted-living centers do not provide medical care. This type of housing may
be a good choice for people who have early, mild Alzheimer's disease or another
dementia and can't live alone but who can still do many daily tasks on their own.

Residential care—which
includes board-and-care homes, retirement homes, and foster-care homes—usually
provides a greater level of supervision than assisted living. These centers
offer community-style housing, meals, laundry and cleaning services, and help
with other personal needs. They do not provide daily medical care. This kind of
care may work well for a person with mild to moderate Alzheimer's disease or
other dementia who needs daily help and supervision but doesn't need daily
nursing care. These centers don't cost as much as nursing
homes.

Skilled nursing facilities provide skilled nursing
care up to 24 hours a day. They offer medical care; medicines; housing; meals;
laundry; help with dressing, bathing, and using the toilet; and other support.
This is the most costly type of care in a center. But it may be the best choice
for many people who have advanced dementia.

Special care units (SCUs), such as memory care, are offered at some residential care centers and
nursing homes. They focus on the needs of people with dementia. They have staff
trained to work with people who have dementia. Studies haven't yet shown that
these units are better than regular centers. Also, they can cost more than
other types of care.

Continuing-care communities offer several levels of care. They offer assisted living up
to full nursing care in the same place. These centers cost a lot. But they may
be a good choice, because they can meet the person's changing needs.

You also could provide around-the-clock home care with
health professionals. This option costs more than a nursing home. You would
have to hire, supervise, and work with a team of caregivers.

Some
people find that part-time help allows them to keep their relative at home for
a longer time. Part-time care may take place either at home or in an adult day
care.

As in long-term care centers, home care can provide whatever help a person needs. For example, a home
health aide can help the person bathe and can wash clothes and linens. A nurse can
give medical care and help with behavior issues.

Adult day care and respite services take care of the person so
that the regular caregiver can take a break. This may relieve some of the
stress of caregiving.

Compare your options

Your loved one lives in a care
center. You can visit as much as you want.

The type of care you choose depends on whether your loved one can
still take care of his or her daily needs and on what the family can
afford.

Your relative has personal care,
meals, and other needs met.

In a nursing home, your relative also can get medical
care.

A care center may have activities and social outlets to keep
your loved one involved and happy.

Staff members are trained to
help people keep up their mental skills as much as possible.

You
may be able to focus on your relationship with your loved one, not on his or
her daily care.

You may feel guilty
if you think that you should be caring for your loved one.

You won't know how he or she is doing at every moment of the day
or be able to make sure that he or she is treated well.

Care at a
nursing home or other center can cost a lot.

Care for your loved one
at home Care for your loved one
at home

You take care of your loved one's
needs at home. This may mean helping with cooking, eating, going to the toilet,
bathing, and dressing.

You need to be able to make sure your loved
one is safe from accidents and can't wander from your home.

You may be able to get part-time help with a home health aide,
adult day care, or respite care.

You can be sure that your relative is
okay at all times.

You can spend more time with your relative.

Care at
home costs less than at a center.

You may feel that your loved one
will be happier at home.

Caregiving can be very
hard on your body and your emotions.

You may have little time for yourself.

Your loved one
may not be safe if you can't provide constant supervision.

Your
loved one may have other health problems that need more care than you can
give.

Personal stories about moving a relative with Alzheimer's or other dementia into long-term care

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I had
always told myself that I would never place my husband George in a nursing
home, and I kept him at home as long as I possibly could. But he started
getting aggressive, throwing things and threatening me and other people who
came to visit. His doctor gave us some medicine, but it didn't seem to help
much. In the end, it just seemed too dangerous to keep George at home. I was
afraid he would hurt himself or maybe hurt me, even though I know he didn't
know what he was doing.

Louise, age 66

My husband and I thought about putting my
mom in a care center, but we've decided to keep her here with us for now. We
visited several different facilities, but we couldn't find one nearby that we
felt comfortable with. If my mom were in a nursing home, I would probably spend
so much more time worrying about her that it just wouldn't be worth it.
Fortunately, we can afford to hire some part-time help so that we have time for
work and other activities. I'm not sure we could keep doing this without that
help.

Elizabeth, age
51

My dad was diagnosed with Alzheimer's
disease several years ago. For most of the time since then, he's been living
with my wife and me and our kids. Taking care of him is a lot of work, and we
don't have any other family nearby who can help out. And with our jobs and the
kids and other responsibilities, we just can't give him the level of attention
he needs. I think he'll get better care in a facility than we can give him
here.

Jeff, age
49

As long as Howard doesn't get violent, I
plan to keep him at home with me. Some days it's really hard, and I think to
myself, "Am I really making a difference here? Would he even realize it if he
were living somewhere else?" He's still my husband, though, and I know he would
do the same thing for me if the shoe were on the other foot. I just wouldn't
feel right letting other people take care of him.

Marianna, age 65

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to move your loved one into long-term care

Reasons to care for your loved one at home

My relative has several health problems that need care.

My loved one has mild Alzheimer's but no other health problems.

More important

Equally important

More important

I can't give my loved one constant supervision.

I am able to give my loved one constant supervision.

More important

Equally important

More important

I don't mind having other people care for my loved one.

I don't feel right about other people taking care of my loved one.

More important

Equally important

More important

My loved one and my family can afford a care center.

My loved one and my family can't afford a care center.

More important

Equally important

More important

My own health and family life are suffering because of caregiving.

I'm able to take care of my needs and my family's needs.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

A care center

Home care

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do all people with Alzheimer's or other dementia need to move to a care center?

YesSorry, that's not right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.

NoThat's right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.

I'm not sureIt may help to go back and read "Get the Facts." People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.

2.

Do care centers offer different types of care with varying quality and costs?

YesThat's right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.

NoNo, that's not right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.

I'm not sureIt may help to go back and read "Get the Facts." Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.

3.

Can part-time help or respite care help you keep your loved one at home longer?

YesThat's right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

NoSorry, that's not right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

I'm not sureIt may help to go back and read "Get the Facts." Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Care for your relative at home. Some caregivers also may want
to think about part-time care at home with a health aide or a nurse or in an
adult day care.

Move your relative into a nursing home or other
long-term care, such as assisted living or a special care unit like memory care.

Key points to remember

People with
Alzheimer's or other
dementia need a safe, structured environment. You may
be able to provide this at home. In other cases, long-term care in a center is
a better choice.

People with dementia usually need more and more
care as time goes by. At some point, your relative will most likely have to be
moved to a long-term care center.

A care center may offer your
loved one some people to talk to plus activities and outings. These
social contacts may keep him or her active for as long as possible.

Caring at home for someone who has dementia takes a lot of time
and work. It also costs money if you hire part-time help. Caring for a loved
one at home also may take time away from other areas of your life. Every family
has different needs and limits to think about.

By using adult
day-care programs and part-time help—whether hired or through family and
friends—you may be able to keep your loved one at home
longer.

Remember that your own health, both physical and emotional,
is as important as that of the person you're caring for.

Deciding
to move your relative into long-term care is not a sign of failure in your role
as caregiver.

FAQs

What happens as Alzheimer's disease or other dementia gets worse?

The care a person needs increases as the disease gets
worse.

Basic activities such as eating, dressing,
bathing, using the bathroom, and simply moving around become harder or
impossible without help.

Safety is a concern. Your loved one may be
more likely to have an accident or to wander from home.

Taking care of the person at home often becomes too hard
on your body and your emotions. Your loved one's behavior can be frustrating or
dangerous. He or she may get angry or abusive. These behaviors are often the
biggest challenge for caregivers.

What kinds of long-term care are available?

"Nursing home" is commonly used to refer to any long-term care, but there
are several kinds of centers. Each provides different levels of medical care,
help with daily living, programs, and support. The quality and costs of care
and services vary widely. Your community may not have all of these
choices.

Assisted-living centers usually provide private, apartment-style housing and offer a range of
services. These services may include meals, cleaning and laundry services, and
help with personal needs such as bathing, grooming, and dressing.
Assisted-living centers do not provide medical care. This type of housing may
be a good choice for people who have early, mild Alzheimer's disease or another
dementia and can't live alone but who can still do many daily tasks on their own.

Residential care—which
includes board-and-care homes, retirement homes, and foster-care homes—usually
provides a greater level of supervision than assisted living. These centers
offer community-style housing, meals, laundry and cleaning services, and help
with other personal needs. They do not provide daily medical care. This kind of
care may work well for a person with mild to moderate Alzheimer's disease or
other dementia who needs daily help and supervision but doesn't need daily
nursing care. These centers don't cost as much as nursing
homes.

Skilled nursing facilities provide skilled nursing
care up to 24 hours a day. They offer medical care; medicines; housing; meals;
laundry; help with dressing, bathing, and using the toilet; and other support.
This is the most costly type of care in a center. But it may be the best choice
for many people who have advanced dementia.

Special care units (SCUs), such as memory care, are offered at some residential care centers and
nursing homes. They focus on the needs of people with dementia. They have staff
trained to work with people who have dementia. Studies haven't yet shown that
these units are better than regular centers. Also, they can cost more than
other types of care.

Continuing-care communities offer several levels of care. They offer assisted living up
to full nursing care in the same place. These centers cost a lot. But they may
be a good choice, because they can meet the person's changing needs.

You also could provide around-the-clock home care with
health professionals. This option costs more than a nursing home. You would
have to hire, supervise, and work with a team of caregivers.

What are the choices for part-time care?

Some
people find that part-time help allows them to keep their relative at home for
a longer time. Part-time care may take place either at home or in an adult day
care.

As in long-term care centers, home care can provide whatever help a person needs. For example, a home
health aide can help the person bathe and can wash clothes and linens. A nurse can
give medical care and help with behavior issues.

Adult day care and respite services take care of the person so
that the regular caregiver can take a break. This may relieve some of the
stress of caregiving.

2. Compare your options

Move your loved one into
long-term care

Care for your loved one
at home

What is usually involved?

Your loved one lives in a care
center. You can visit as much as you want.

The type of care you choose depends on whether your loved one can
still take care of his or her daily needs and on what the family can
afford.

You take care of your loved one's
needs at home. This may mean helping with cooking, eating, going to the toilet,
bathing, and dressing.

You need to be able to make sure your loved
one is safe from accidents and can't wander from your home.

You may be able to get part-time help with a home health aide,
adult day care, or respite care.

What are the benefits?

Your relative has personal care,
meals, and other needs met.

In a nursing home, your relative also can get medical
care.

A care center may have activities and social outlets to keep
your loved one involved and happy.

Staff members are trained to
help people keep up their mental skills as much as possible.

You
may be able to focus on your relationship with your loved one, not on his or
her daily care.

You can be sure that your relative is
okay at all times.

You can spend more time with your relative.

Care at
home costs less than at a center.

You may feel that your loved one
will be happier at home.

What are the risks and side effects?

You may feel guilty
if you think that you should be caring for your loved one.

You won't know how he or she is doing at every moment of the day
or be able to make sure that he or she is treated well.

Care at a
nursing home or other center can cost a lot.

Caregiving can be very
hard on your body and your emotions.

You may have little time for yourself.

Your loved one
may not be safe if you can't provide constant supervision.

Your
loved one may have other health problems that need more care than you can
give.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about moving a relative with Alzheimer's or other dementia into long-term care

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I had always told myself that I would never place my husband George in a nursing home, and I kept him at home as long as I possibly could. But he started getting aggressive, throwing things and threatening me and other people who came to visit. His doctor gave us some medicine, but it didn't seem to help much. In the end, it just seemed too dangerous to keep George at home. I was afraid he would hurt himself or maybe hurt me, even though I know he didn't know what he was doing."

— Louise, age 66

"My husband and I thought about putting my mom in a care center, but we've decided to keep her here with us for now. We visited several different facilities, but we couldn't find one nearby that we felt comfortable with. If my mom were in a nursing home, I would probably spend so much more time worrying about her that it just wouldn't be worth it. Fortunately, we can afford to hire some part-time help so that we have time for work and other activities. I'm not sure we could keep doing this without that help."

— Elizabeth, age
51

"My dad was diagnosed with Alzheimer's disease several years ago. For most of the time since then, he's been living with my wife and me and our kids. Taking care of him is a lot of work, and we don't have any other family nearby who can help out. And with our jobs and the kids and other responsibilities, we just can't give him the level of attention he needs. I think he'll get better care in a facility than we can give him here."

— Jeff, age
49

"As long as Howard doesn't get violent, I plan to keep him at home with me. Some days it's really hard, and I think to myself, "Am I really making a difference here? Would he even realize it if he were living somewhere else?" He's still my husband, though, and I know he would do the same thing for me if the shoe were on the other foot. I just wouldn't feel right letting other people take care of him."

— Marianna, age 65

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to move your loved one into long-term care

Reasons to care for your loved one at home

My relative has several health problems that need care.

My loved one has mild Alzheimer's but no other health problems.

More important

Equally important

More important

I can't give my loved one constant supervision.

I am able to give my loved one constant supervision.

More important

Equally important

More important

I don't mind having other people care for my loved one.

I don't feel right about other people taking care of my loved one.

More important

Equally important

More important

My loved one and my family can afford a care center.

My loved one and my family can't afford a care center.

More important

Equally important

More important

My own health and family life are suffering because of caregiving.

I'm able to take care of my needs and my family's needs.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

A care center

Home care

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Do all people with Alzheimer's or other dementia need to move to a care center?

Yes

No

I'm not sure

That's right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.

2.
Do care centers offer different types of care with varying quality and costs?

Yes

No

I'm not sure

That's right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.

3.
Can part-time help or respite care help you keep your loved one at home longer?

Yes

No

I'm not sure

That's right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Anne C. Poinier, MD - Internal Medicine

Specialist Medical Reviewer

Myron F. Weiner, MD - Psychiatry, Neurology

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